GEM PRIMARY HEALTHCARE LLC. NPI 1457072647

NPI Information

NPI: 1457072647
Provider Name: GEM PRIMARY HEALTHCARE, LLC.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2277398

Address:
175 COUNTRY CLUB DR BLDG 100D
STOCKBRIDGE, GA
ZIP 30281
Phone: (678) 819-5497
Get Directions

GEM PRIMARY HEALTHCARE, LLC. is a primary care clinic center in Stockbridge, GA. GEM PRIMARY HEALTHCARE, LLC. NPI is 1457072647. The provider is registered as an organization entity type.

The provider's business location address is:

175 COUNTRY CLUB DR BLDG 100D
STOCKBRIDGE, GA
ZIP 30281-380
Phone: (678) 819-5497
Fax: (678) 601-1508

The provider's authorized official is Geraldine Eccleston Menchion .
The authorized official title is Np and has the following contact phone number (404) 514-6066.

The CLIA number assigned to this NPI record is 11D2277398 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/7/2022 and was last updated on 3/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »